ACL Policy Round-Up

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By: Vicki Gottlich, Director – Center for Policy and Evaluation

The ACL Policy Round-Up is a new blog feature intended to help the aging and disability networks stay informed about new policies (and policy changes) that impact our work, and to ensure our networks are aware of opportunities to provide input on issues that affect older adults and people with disabilities. Please let us know what you think!

This first round-up includes some highlights from the last few weeks.

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Medicaid coverage of non-emergency medical transportation

Quick summary: The Consolidated Appropriations Act, 2021 includes language that helps to remove transportation barriers for people with Medicaid seeking needed healthcare. Specifically, the law requires states to ensure necessary transportation for Medicaid beneficiaries to and from covered services; requires states to establish payment rates to ensure that Medicaid beneficiaries have the same access to non-emergency medical transportation (NEMT) as people who are not covered by Medicaid; and establishes new requirements for NEMT providers and drivers. On July 12, the Centers for Medicare & Medicaid Services (CMS) issued an informational bulletin to explain these provisions.

In formulating their plans, states are required to consult with stakeholders, so it’s important for the aging and disability networks to be aware of the new requirements and your state’s planning so that your input can be included. Read more.


CMS announces $15M in grants to help states bolster mobile crisis intervention services

Quick summary:  The Centers for Medicare & Medicaid Services (CMS) announced a $15 million funding opportunity for planning grants to help strengthen system capacity to provide community-based mobile crisis intervention services for those with Medicaid. (The grants are available to state Medicaid agencies.)

Funded by the American Rescue Plan, the grants can be used to support states’ assessments of their current services, strengthen capacity and information systems, ensure that services can be accessed 24 hours a day/365 days a year, provide behavioral health care training for multi-disciplinary teams, or to seek technical assistance to develop State Plan Amendment (SPAs), demonstration applications, and waiver program requests under the Medicaid program.

This presents an important opportunity for the ACL network to coordinate with state Medicaid agencies and mental health systems to ensure the unique needs of older adults and people with disabilities are addressed as they develop, prepare for, and implement these programs. Read more.


Input needed: Proposed Rules

Department of Labor proposed rule prevents sub-minimum wage for federal contractors with disabilities: On July 22, the Department of Labor (DOL) published a notice of proposed rulemaking (NPRM) raising the minimum wage for federal contractors, including people with disabilities.

  • The proposed rule would implement an executive order signed by President Biden in April, raising the minimum wage for federal contractors from its current rate of $10.95 per hour to $15 per hour, beginning on January 30, 2022.
  • Most important for ACL’s networks, the proposed rule continues the provisions of the 2014 final rule, which effectively ended the practice of using special certificates issued under section 14(c) of the Fair Labor Standards Act to pay people with disabilities less than the minimum wage for the majority of federal contracts. It ensures that, in most cases, federal contractors with disabilities receive the same minimum wage as other federal contractors.
  • DOL is currently seeking public comment on the proposed rule. Comments can be submitted online or by mail, and the deadline has been extended through August 27, 2021.

Centers for Medicare & Medicaid Services (CMS) proposed rule would increase access to benefits for direct service providers (DSP): The DSP workforce is the backbone of our country’s home and community-based services (HCBS) system. However, low pay and absence of benefits (together with other factors), have caused high rates of turnover and recruiting challenges. These issues have, in turn, created critical workforce shortages and negatively affected the quality, stability, and availability of services.

  • On July 30, CMS published a notice of proposed rulemaking (NPRM)to give states the ability to make health insurance and other employee benefits more accessible to this essential workforce.
  • The proposed rule would allow state Medicaid agencies to deduct from a practitioner’s Medicaid payment, with the individual’s consent, to pay third parties for benefits such as health insurance and skills training. This creates a pathway for direct service providers and other practitioners to enroll in, pay for, and retain employee benefits.
  • The proposed rule reverses a 2019 final rule that prohibited states from making these types of payments.
  • CMS is currently seeking public comment on the proposed rule. Because this rule would affect many in the Medicaid HCBS workforce, which in turn has a direct and immediate impact on the quality of and access to services available to Medicaid beneficiaries, input from the aging and disability networks is crucial. Comments can be submitted online or by mail until September 28, 2021.

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